The present invention relates generally to closed suction catheter assemblies used in respiratory applications.
There are a number of different circumstances in which it is necessary for a person to have an artificial airway, such as a tracheostomy tube, placed in his or her respiratory tract. As used herein, the phrase xe2x80x9cartificial airwayxe2x80x9d includes devices such as tracheostomy tubes, endotracheal tubes, and the like. Artificial airways keep the patient""s natural airway open so that adequate lung ventilation can be maintained.
In certain situations, the artificial airway must be left in the patient for a prolonged period of time. For example, many persons suffering severe neck or head trauma use a tracheostomy tube in conjunction with mechanical ventilation during extended recovery and rehabilitation periods. In other situations, patients may require an artificial airway for an extended period of time without mechanical ventilation. In these situations, it is critical that respiratory secretions be periodically removed. This is typically accomplished by the use of a respiratory suction catheter that is advanced into and through the tracheostomy tube. As the suction catheter is withdrawn, a negative pressure (or vacuum) is applied to draw mucus and other secretions from the patient""s airways and the interior of the artificial airway. While a substantial amount of the mucus and other secretions will be withdrawn through the lumen of the suction catheter, a portion of the mucus and other secretions will remain as a film on the outside of the catheter.
Patient secretions can contain infectious agents, such as streptococcus, pseudomonas, staphylococcus, and even HIV. It is, therefore, important to shield the clinician from contact with the catheter. Using an uncovered catheter, or xe2x80x9copenxe2x80x9d catheter, thus poses health risks to the clinician. When the catheter is withdrawn from the tracheostomy tube, the exterior of the catheter may be coated with patient secretions and it is often necessary to repeat the procedure two or three times. With each advancement and retraction of the catheter, the clinician has to be concerned with not only suctioning the patient, but also with avoiding contact with the potentially infectious agents on the exterior of the catheter. In addition, the clinician must be concerned with preventing the catheter from being accidentally contaminated with microbes from the surrounding area, for example the patient""s gown, bed clothing, and other surrounding items which may transmit microbes. It is, therefore, equally as important to shield the patient from communicable pathogens in the environment and those that may be carried by the clinician.
A problem also arises with repeated attachment and detachment of the catheter assembly to a tracheostomy tube since the constant application of force against the tracheostomy tube causes irritation and discomfort to the patient. Another problem posed with repeated attachment and detachment of the catheter assembly is that two hands are generally required. One hand stabilizes the tracheostomy tube while the other pushes the distal end of the catheter assembly onto the tracheostomy tube or pulls the distal end away from the tracheostomy tube. (As used herein, xe2x80x9cdistalxe2x80x9d refers to the direction of the patient and xe2x80x9cproximalxe2x80x9d refers to the direction of the clinician.)
In a closed suction catheter assembly, as set forth in U.S. Pat. Nos. 3,991,762 and 4,569,344, the catheter may be enveloped by a protective sleeve and include a valve mechanism disposed near the vacuum source. These features reduce the risk of contamination to both the patient and the care giver. At its distal end, the closed suction catheter may be attached to an artificial airway via one of a variety of connectors, including, for example, a multi-legged tracheostomy connector. One of the legs of the tracheostomy connector may be connected to a tracheostomy tube located within an aperture formed in the throat of the patient. When it is desired to remove secretions or mucus from the patient, the catheter is advanced through the connector and into the tracheostomy tube. Negative pressure is then applied to the other end of the catheter and secretions within the patient""s respiratory system are evacuated. With the use of the closed suction catheter assembly, the ventilating circuit need not be detached from the patient during suctioning, and a single catheter may be used for an extended period, typically a 24-hour period.
Thus, there is a need for an adaptor for attachment of a closed suction catheter assembly to a tracheostomy tube or other artificial airway that effectively addresses at least some of the problems noted with conventional closed suction catheter assemblies.
Objects and advantages of the invention will be set forth in part in the following description, or may be obvious from the description, or may be learned through practice of the invention.
The present invention is directed to an adaptor for use with a closed suction catheter assembly for attachment to an artificial airway, such as a tracheostomy tube. It should be appreciated that the adaptor of the present invention may be described herein with reference to a xe2x80x9ctracheostomy tubexe2x80x9d in particular. This is for illustrative purposes only and it should be understood that the adaptor may be utilized with any configuration of an artificial airway.
The adaptor is configured to permit engagement with an artificial airway, such as a tracheostomy tube. A housing member defines an internal chamber in communication with the tracheostomy tube that allows a patient to simultaneously breathe through the tube and adaptor. In one embodiment, a series of projections or ribs extend radially inward within the housing of the adaptor, thereby defining channels which enable the patient""s ability to breathe.
The adaptor may contain within the housing an oxygen port for patients having reduced respiratory capacity. As such, the oxygen port permits the introduction of oxygen or oxygen enriched air to the patient.
The adaptor also may contain a means for cleaning mucus and other secretions from the external surface of the catheter. In one embodiment, the housing of the adaptor may have a lavage port to assist in cleaning. A cover may be provided for isolation of the catheter from the atmosphere during cleaning.
Further, the adaptor of the invention, when used with a closed suction catheter assembly, safeguards the clinician from contamination by keeping the external surface of the catheter either within the protective sleeve of the closed suction catheter assembly or within the adaptor housing. The isolation of the catheter further safeguards the patient by keeping microbes and other surrounding contaminants away from the external surface of the catheter.
The adaptor also facilitates release of the closed suction catheter assembly from the tracheostomy tube and, thus, the patient. A release assembly may include an extension mechanism attached to a release member. When force is applied to the release assembly, the distal end of the closed suction catheter assembly disengages itself from the adaptor flange of the tracheostomy tube. The adaptor permits single-handed detachment without undue movement of the tracheostomy tube.
In one embodiment, the adaptor is formed with a release plate and a pair of arms which attach the plate to the closed suction catheter assembly. The arms are formed so that when pressure is applied thereto, the arms extend, causing the release plate to disengage the adaptor flange of the tracheostomy tube, forcing the distal end of the catheter assembly to move away from the proximal end of the tracheostomy tube.
In accordance with another aspect of the present invention, the release plate may be movable so that a portion of the plate covers the distal end of the catheter to help prevent cross-contamination.
In another embodiment, the adaptor may include a filter for patients who require filtered air. The release mechanism and the filter may form an integrated adaptor unit which is detachable from the closed suction catheter assembly and the tracheostomy tube.
In accordance with yet another aspect of the present invention, the release assembly can be integrated with the manifold of a closed suction catheter assembly which is configured for use on a ventilated patient.